Epidemiologic Notes and Reports Imported Dog and Cat Rabies -- New Hampshire, California

In 1987, rabies was reported in a dog in New Hampshire and a cat in California. Both animals had been recently imported from Mexico.

New Hampshire. The first case of dog rabies in New Hampshire since 1967 was confirmed on January 17, 1988, in a 5-month-old puppy that had been imported into the United States 3 weeks earlier. The dog was presented to a veterinarian on January 16 because of whimpering, tremors of one leg for 3 days, urinary and fecal incontinence for 12 hours, and excessive salivation for 2 hours. Based on the puppy's history and symptoms, the veterinarian suspected rabies, and the dog was euthanized.

The dog was brought into New Hampshire by a 13-year-old girl who adopted it while visiting her mother near Mexico City. The dog was immunized against parvovirus, but not rabies, by a veterinarian in Mexico who also issued a health certificate for the dog the day before departure. The girl flew with the dog from Mexico City to New York City on December 30. On arrival, a U.S. Customs official at the airport briefly inspected the puppy and questioned the girl about its health. She presented the health certificate, and the dog was permitted entry without proof of rabies immunization or the required isolation at the final destination. The girl and dog arrived in New Hampshire on December 31.

The girl brought the dog to school, various parties, and babysitting jobs. Seventeen people received rabies postexposure prophylaxis primarily because of facial exposure to the dog's saliva. The total cost of doctors' visits, rabies vaccine, and rabies immune globulin was $12,100.

California. A similar case of imported animal rabies from Mexico occurred in a cat in Los Angeles (1). In September 1987, a stray cat of unknown rabies immunization status was adopted by a woman vacationing in Acapulco. The cat passed through U.S. Customs even though it was sick at the time. The woman presented the cat to three veterinarians; based on its history and symptoms (including incoordination, nervousness, twitching, salivation), two of the three suspected rabies and recommended euthanasia. Four days after arrival, the cat died and was found positive for rabies. Twenty persons subsequently received rabies postexposure prophylaxis.

All U.S. Customs officials have been notified of these incidents and have been reminded that proof of rabies immunization must accompany all dogs greater than or equal to3 months of age entering the United States from rabies-endemic countries and that all animals must be in good health upon entry. Reported by: TW de Marr, DVM, Walpole Veterinary Clinic, Walpole; IA Pratt, FE Shaw Jr, MD, State Epidemiologist, New Hampshire Div of Public Health Svcs. CP Ryan, DVM, KE Weeks, JE Rolands, Los Angeles County Dept of Health Svcs; KH Acree, MDCM, Acting. State Epidemiologist, California Dept of Health Svcs. Div of Field Svcs, Epidemiology Program Office; Viral and Rickettsial Zoonoses Br, Div of Viral Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: Dog and cat rabies is hyperendemic in Mexico and most countries of Africa, Asia, and Central and South America (2,3). Dog rabies is extremely rare in the New England states; the most recent cases were reported from Maine and Vermont in 1978 (4). Veterinarians should suspect rabies when a dog, cat, or other susceptible animal is imported from a rabies-hyperendemic area and develops an unexplained rapidly progressive neurologic disease.

Public Health Service quarantine regulations (42 CFR 71.51) require that all dogs greater than or equal to3 months of age imported from countries not free of rabies have a valid rabies vaccination certificate and be vaccinated at least 30 days before entering the United States (5). Unimmunized dogs may be permitted entry if they are vaccinated for rabies and confined for at least 30 days after vaccination. However, a recent case of rabies in an imported dog, which occurred despite appropriate rabies immunization before entry, illustrates that these regulations, even when followed correctly, may not always prevent imported rabies (6). It is highly recommended that cats from rabies-hyperendemic countries be immunized before entry. Dogs, cats, and other rabies-susceptible animals should not be imported as pets from rabies-hyperendemic countries. Travelers to such countries should not take their pets with them or acquire pets abroad unless absolutely necessary.

References

1. California Department of Health Services. Symptomatic rabid cat arrives in Los Angeles on airliner from Mexico and is passed through port-of-entry. Calif Morbid 1988;13:1.

2. CDC. Rabies surveillance 1986. MMWR 1987;36(suppl 3S):20S.

3. World Health Organization. World survey of rabies XXII (for years 1984/85). Geneva: World Health Organization, Division of Communicable Diseases, 1987.

4. CDC. Rabies surveillance annual summary 1978. Atlanta: US Department of Health and Human Services, Public Health Service, 1981.

5. Public Health Service. Importations: dogs and cats. Federal Register 1986;42:54-6.

6. CDC. An imported case of rabies in an immunized dog. MMWR 1987;36:94-6,101.

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